MIXED land

[Loon-A-TiK]

Mixed land is the worst for me. It is in mixed land when I have psychosis and am most suicidal. Depression and mania both feel "safer" and more in control

What are your experiences?

[Dweii]

Yeah, it's the worst for me too. I hate hate hate it. And recently it has happened a lot. I didn't know what it was at until pdoc suggested it was a mix of mania and depression. And that's really what it is. A depressing mania. Could it get worse? You wanna die and you have all the energy in the world to actually go through with it.

Hopefully now that my Lithium levels are back up it will calm down.

My symptoms would be: Racing thoughts, tingling feeling in my body, negative thoughts, extreme irritability, wanting to die, tons of energy all focused on my negative thoughts, wanting to fight

[Thomas]

I hate mixed too; being so depressed I can't stop weeping and at the same time having enough energy that I feel like I'm going to blast-off like a rocket if I sit still for a minute longer.  Then I get more depressed thinking about how hyper I am.

Tommy

[revlow]

I hate mixed too; being so depressed I can't stop weeping and at the same time having enough energy that I feel like I'm going to blast-off like a rocket if I sit still for a minute longer.

[Anne]

I think mixed land is where I was living for the last 40 years and I'm just now climbing out and seeing what real life is all about!  What a waste of time.  Too bad I can't have all that energy and be happy about it.  It seems I can only be happy and lazy, or energetic and crazy, depressed and irritable - with a really clean house.

[ehygon]

My symptoms would be: Racing thoughts, tingling feeling in my body, negative thoughts, extreme irritability, wanting to die, tons of energy all focused on my negative thoughts, wanting to fight

<{POST_SNAPBACK}>

minus the tingle, thats how i feel right now. i mostly can't stay still, like, there is a dent worn into the carpet in front of my computer, because when i'm in any state, I sit down here, bounce my foot like whoa, and try to zone out. not that it works.

[synthetic]

racing thoughts, feeling like i am on a permanent adrenaline rush, negative thoughts galore on crack, pissed the fuck off, i wish i was dead, too much energy and no way to get it out, anxiety out the ass, if i could just slow down, i would kill myself, emotions way too intense

[Min]

oh i can't stand it.  it's like 'i want to die!! grr i hate everyone they should die too!' then 'oh, i want to give everyone a hug!  i'm so blessed to have the life i have!  let's spend money!' then i get this state to where i'm sort of stable and figure out what's going on which i think is REALLY bad, then rinse and repeat.

and yes i am the most suicidal in mixed states.  i can't stand them.  i pop a clonazepam once i figure out what's going on.

[Dweii]

Has anybody found a "cure" for mixed states? And I mean apart from a working mood stabilizer. What do you all use as emergency meds?

For me, Haldol works if the mixed state is more on the manic side and I need to calm the fuck down. If it's really bad though, nothing works except an elephant dose of Xanax to knock me out.

[Min]

Has anybody found a "cure" for mixed states? And I mean apart from a working mood stabilizer. What do you all use as emergency meds?

For me, Haldol works if the mixed state is more on the manic side and I need to calm the fuck down. If it's really bad though, nothing works except an elephant dose of Xanax to knock me out.

<{POST_SNAPBACK}>

a benzo, or trying to sleep.

[synthetic]

Has anybody found a "cure" for mixed states? And I mean apart from a working mood stabilizer. What do you all use as emergency meds?

For me, Haldol works if the mixed state is more on the manic side and I need to calm the fuck down. If it's really bad though, nothing works except an elephant dose of Xanax to knock me out.

<{POST_SNAPBACK}>

Zyprexa is pretty much the standard emergency med for mania and mixed states.  I know you didn't enjoy your experience on Zyprexa, but for a "this has to stop fucking now" moment, it is the best choice, at least for me.  You may be a zombie for a day or two, but that is better than the alternative.  Of course, once it wears off, you are back where you started.

[groovyone]

Yes, I've only tried Zyprexa.

[Thomas]

Well, on my third day of taking my benzos (klonopin) at set times, my anxiety seems somehwat less and it is the biggest manic component of my mixed states.  It ain't doin' sh&t for the depression thoough

Tommy

[Weaseltine Cracker]

Thanks Loon for starting this thread. It's really helpful to hear about everyone's experiences.

I'm a bit spooked about all I'm reading about mixed states and a recent nasty episode I had. I've not been officially dx'd BP, but am suspicious (as is my tdoc) and will bring this up with my pdoc in two weeks. Here are the pertinent details:

--Have taken 40 mg. fluoxetine/day for anxiety/OCD/MDD for 8 years.

--Had experienced some hypomania on trying 80 mg fluoxetine (rec. dose for anxiety) so stepped back.

--Experienced euphoric hypomania for 6 months last spring semester. Stopped taking fluoxetine cold turkey because I felt so damn good.

--Started stressful new summer internship.

--On getting period a few days into internship, experienced out-of-the-blue extreme anxiety (difficult sleep, racing thoughts, hypervigilant, loss of appetite, weight loss, negative thoughts, depressed thoughts) and basically an overall out-of-control awful feeling. Started fluoxetine immediately.

--Extreme anxiety state continues for five months straight without abating until starting 30 mg. buspirone/day.

Since the anxiety (mixed state??) abated, I've had days where I feel as if a euphoric hypomania is coming on, days when I'm so jittery and anxious that I can't focus on work I have to do, and days when I feel just even-keeled. Mostly I've been even.

Has anyone else experienced this train of events or something similar?

--Weasel

[ncc1701]

Heya Loon,

Thanks also for starting this thread.  There are a lot of us, it seems, who have mixeds and not just pure "euphoric" manias.

Sounds like there *are* common threads to our mixeds, which is actually reassuring in its own small way.

Mixed for me, which I *used to think* was my personality, no really:

Can't sleep.  Up all night, all day, all night.  Sleeping leads to endless nightmares anyway. 

Too busy to eat, but not getting anything done either. 

Mad as hell, rage rage rage, pretty much at me and everyone, and God help you if you cross my path. 

Thinking too fast to talk, talking too fast to be understood. 

But the thoughts are depressed, dammit, end-of-the-world, crash-the-car-b/c-I-want-to-die-in-a-fiery-collision-and-take-you-all-with-me. 

Then I drink, b/c I think it will help, and it gets worse.

Only had one since on Lamictal, about 2-3 weeks' worth and kind of low-intensity.  For anyone who remembers, I'm pretty sure the timing coincided with some big-gun antibiotics I was taking.  With any kind of luck, I'll see the next one coming.

I'm still getting used to *not* being mixed (1-2 weeks q3-4 months) or deeply depressed (7-8 months/year).

It's been six months.  Almost to the day.

I have no prn's yet.

It feels fragile.

--ncc--

[Amethyst]

Mixed is definately the worst. For me it is definately the dark suicidal thoughts combined with the energy to actually do it. That makes it the most dangerous of all phases.

Other symptoms I have: can't sleep and just sit up thinking about how terrible things are or coming up with ways to die, literally pace back and forth for hours, stuff my face full of food (and get even more depressed) and the worst, which comes from the racing thoughts and restless is I just aint comfortable in my own skin. I want to tear it off!

Lovely picture I've painted!

Ameth

[jillbelle]

Great topic, Loon.

I'm actually in a mixed-state right now, thanks to my four days on 25mg of Zoloft. Come to think of it, most of my time is spent in mixed states. Yes, I've experienced euphoric hypomania from SSRI's, as well as out of the blue, but 99% of my hypomanias are of the mixed-state variety. (By the way, I'm BP II, so everything is "hypo", right?)

Anyway, for me, it's the worst depression and the worst anxiety happening at the same time. It's feeling too depressed to function, while simultaneouly feeling like I'm going 100mph inside. The energy is dysphoric, though. It's severe anxiety and agitation. I feel like I'm crawling out of my skin. I cry. A lot. I also have trouble sleeping, waking up every few hours in states of panic.

I stopped the Zoloft, but the mixed state is still happening. I see the doctor tomorrow (and he already upped my Trileptal), but out of curiosity, once a mixed state has been triggered, how long does it take to abate? Does it just have a mind of its own?

[revlow]

...but out of curiosity, once a mixed state has been triggered, how long does it take to abate? Does it just have a mind of its own?

<{POST_SNAPBACK}>

Great question, Jill. I don't know the answer myself. Very interested in hearing what others have to say.

[synthetic]

out of curiosity, once a mixed state has been triggered, how long does it take to abate? Does it just have a mind of its own?

<{POST_SNAPBACK}>

Yes it does, and it is a sadistic mind.  In my experience, it has taken longer and longer to abate every time I have one, usually after the crap that triggered it has been resolved.  Good news, eh?

[tallulah]

being stuck in a mixed state is very scary for me.

i cant stand being in my own skin. i get so agitated that i can stand to be around anyone (and visa versa - i know). 

a good example would be...

i try to tell myself that everything will be okay; why are you such a fucking idiot? EVERYTHING IS FINE!!! not exactly knowing what im trying to talk myself out of...and within moments it switches, and im hoping that if i drive my car off the road i WILL kill myself and wont be that girl who ends up paralyzed for the rest of her life.

....and you know, the other stuff.  uncontrollable crying, always wanting to fight, extreme energy - all MIXED into one.

ive been threatened with lithium (long story - i keep refusing). although, my last uppage of lamictal worked really well. havent had another episode.

yeah - fun times.

:embarassed:

[Ruby]

Sorry I have nothing beneficial to add here. I'm currently in a mixed episode. The trigger was my husband having a bad accident at work (burned). The mixing was escalated by, what I perceived, as the hosital's apathetic attitude. According to my husband, I was in everyone's face. I didn't feel like I was overbearing. I tell you what, he sure got better treatment.

He had 2nd degree burns on his entire back, neck, and ears. I felt they should have kept him, at least one fricking night. I had to clean and "debreed" the wounds. Not for the squeamish, and I am squeamish. I had an anxiety attack just trying to peel off the skin (looks like med examiner peeling off skin of a drowing victim). Then they gave him pain meds that made him sick. I called in trying to get a different pain med and they wouldn't call it in. They said, "well, he should try taking it with food." Really? Fuck, I'm so stupid I would never come up with that on my own. Thank you for insulting my intelligence and blowing off my husband's condition. Fucktards.

Now I'm also feeling very paranoid. Does anyone else get that way? I know I scare people when I'm like this, but I feel like it's the only way to get things done.

I'm fucking pissed. Want everyone to leave me the fuck alone. And quit talking about me. I want to die. I want to take a flamethrower to any one who enrages me.

My bandaid has been xanax and Chardonnay.

There is no cure. There never will be one. Our illness is the most difficult to treat and the researchers don't care. They'll find a cure for aids and the common cold before they find one for bp.

Yes, I have issues, godammit.

[revlow]

Ruby:

I'm so sorry to hear about everything, how you're feeling, your husband's accident. Unbelievable that they wouldn't keep him in the hospital at least on night! But that's our *lovely* health care system now. Everything seems to be outpatient nowadays, and they leave you to deal with the mess.

One thing you said I might disagree with, to some extent. There are researchers working in this field. Maybe not enough of them, but there are some dedicated people dealing with this. I had the priviledge of knowing one of them years ago, a very compassionate psychopharmacologist, who helped it the research on Effexor. Certainly, I wish there were more researchers on this, but I wouldn't say the ones in this field don't care.

Just FYI, this is a good site to keep up with the latest developments in drugs, where they are in the approval process, etc.: http://neurotransmitter.net/newdrugs.html. While it is dealing primarily with drugs in the U.S. there seem to be a few European ones, as well.

Hope you feel better soon, and that your husband's healing goes well.

revlow

[Guest FrannyNZooey]

out of curiosity, once a mixed state has been triggered, how long does it take to abate? Does it just have a mind of its own?

<{POST_SNAPBACK}>

Yes it does, and it is a sadistic mind.  In my experience, it has taken longer and longer to abate every time I have one, usually after the crap that triggered it has been resolved.  Good news, eh?

<{POST_SNAPBACK}>

Just wanted to add unfortunately so true, for me even with meds therapy.

It was as if my body literally just ate up the benzo's, we 'joked" I needed elephant tranquilizer, I prayed for it.

That is when my suicide attempt came.

So, please no matter how much you can even appear witty at the doctors because you hate the friggin hospital, let someone know, some how, I know it is tough in that mind, but being so close there and back, I do choose here.

And now I would tell, still not hospital, but hubby to be on watch, meaning giving him all my meds, and staying in bed with him, even if reading on floor so really in room, doing yoga whatever, just not leaving that room.

I hate to sound so scary, but it can be, it is a life threatening illness.

God I am crying again, from my guilt, but it is less, it is.

Love, Aly

[groovyone]

God I am crying again, from my guilt, but it is less, it is.

Love, Aly

<{POST_SNAPBACK}>

Oh Aly, as I read this I feel so sad.  But you made it! You're still here with us and that is a very good thing.  I know you're still in pain and I'm glad the guilt is lessening.  I won't pretend to be able to know your feelings.  They are your own and guilt is so hard to absolve yourself of...see my tagline (or one of them?) I was even conceived in guilt (my biological father is not the one who raised me and this was kept in secret--I only found out "by accident" at the age of 29.)

My whole life is swaddled in guilt even from conception so I know how powerful it can be.  It is really hard work to not become a slave to it.  I still struggle.

*hug* - not that I do it often but I'm not averse to cyberhugs

Karen

[Guest FrannyNZooey]

Thank you Karen for reaching out, and the Hug.

Guilt is an awesome weight, but we can ease it, with the help of others, lifting it away.

Love, Aly

[groovyone]

Thank you Karen for reaching out, and the Hug.

Guilt is an awesome weight, but we can ease it, with the help of others, lifting it away.

Love, Aly

<{POST_SNAPBACK}>

You're right.  Support is key.  If we try to shoulder the burder all by ourselves we just keep digging ourselves deeper into the proverbial hole.

Take care,

Karen

[Loon-A-TiK]

You all have described, better than I ever could, just how I feel being in Mixed Land. And Jill, just because you carry the DX "hypomanic" doen't mean you can't feel mixed. I think it is a strong feature of all 9million flavors of the BP spectrum.

I am jittery, restless, attacked by racing dark thoughts, hopeless, and tired all at the same time. My normally clean house is starting to look like it was taken over by messy teens.

My pdoc put me on WB today to hopefully stave off the depression anyway, and we are hoping the Abilify will get into my system more and more (newer med for me) to stop the anxious thoughts. I also hypnotize myself to help with the anxious thoughts.

one thing to say

mixed land sucks!   

[Ruby]

Ruby:

I'm so sorry to hear about everything, how you're feeling, your husband's accident. Unbelievable that they wouldn't keep him in the hospital at least on night! But that's our *lovely* health care system now. Everything seems to be outpatient nowadays, and they leave you to deal with the mess.

One thing you said I might disagree with, to some extent. There are researchers working in this field. Maybe not enough of them, but there are some dedicated people dealing with this. I had the priviledge of knowing one of them years ago, a very compassionate psychopharmacologist, who helped it the research on Effexor. Certainly, I wish there were more researchers on this, but I wouldn't say the ones in this field don't care.

Just FYI, this is a good site to keep up with the latest developments in drugs, where they are in the approval process, etc.: http://neurotransmitter.net/newdrugs.html. While it is dealing primarily with drugs in the U.S. there seem to be a few European ones, as well.

Hope you feel better soon, and that your husband's healing goes well.

revlow

<{POST_SNAPBACK}>

Revlow,

Thank you for the kind words. I was totally ranting. I feel a little better now. We just got back from the hospital and the wounds are healing.

Thanks for the link. I know there are people in the field that are looking for answers. We did have a 2 yr resident who was fantastic. I forgot about him. He will make an outstanding attending.

Thank you, thank you crazyboards, and thank you fellow nut jobs. You're there when I need you.

[ncc1701]

Heya Ruby,

Sorry, so sorry, I missed your story til now.

Glad you're feeling okay, but that's a hard, hard thing to deal with.

(And, yeah, residents are great.  Maybe he/she was a family practice resident, we're the nicest ones, LOL (spoken as a very recent R2))

And, not to be crass, there is realistically a hell of a lot of cash to be made by whoever figures out the cure for MDD/BP/whatever.  And, as revlow pointed out, a huge current area of research.

Jillbelle asked how self-perpetuating a mixed is.

Does whatever the hell it wants to do, then shoves me into depression for another 3-4 months.

Last week it did whatever the hell it wanted, no sleep, but I was off work so I was somewhat able to fake it when DH was home. 

Mini one, thank GSK for Lamictal and Miclowicz for BPSG.  OK on New Year's, which was very, very important in my (DH's) family.

Also, I think thanks to GSK, the post-mixed depression never really materialized.

So, that's something.

Still, fragile, fragile.

Like those sugar sculptures on the Food channel.

--ncc--